Isherwood Care III

Type of visit: Required - 1 Year

On 08/05/2026 at 8:40 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Lauro Cayabyab and explained the purpose of the visit. Administrator certificate is current. LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 4 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 74 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. The hot water temperature in the residents’ shared bathroom was measured at 111.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 05/28/2026. First aid kit was observed to be complete. Emergency disaster drill was last conducted on 05/30/26. At 8:55 AM, LPA reviewed 2 staff records and 2 of 2 have current first aid training and are associated to the facility. At 9:06 AM, LPA reviewed 4 residents records. At 11:00 AM, LPA reviewed a sample of resident’s medications. Continue to LIC809-C... Continue from LIC809.... Updated copies of the following documents were requested for facility file and are to be submitted to CCLD by 08/12/2026 LIC 610E Emergency Disaster Plan Infection Control Plan THE FOLLOWING DEFICIENCY WAS OBSERVED DURING VISIT: At 10:04 AM, LPA observed two knives in one of the kitchen drawers and S1's medication in the other kitchen drawer unlocked and accessible to residents in care. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiency by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 5, 2026

The state marks this report as 5 pages; the online copy we transcribed has 4. You can request the full file from the county licensing office.

Type of visit: Case Management - Other

On 08/12/2025 at 1:10 PM, Licensing Program Analyst (LPA) P.Manalo arrived unannounced to conduct a case management visit. LPA met with Direct Care Staff, Carmelita Bontilao, and explained the purpose of the visit. Administrator, Lauro Cayabyab, arrived shortly after. The facility sent an updated Physician's Report dated 07/16/2025 for Resident 1 (R1) on 08/06/2025 which indicated that R1 was bedridden. Record review and staff interview revealed that R1 was admitted to hospice on 11/07/2024. No deficiencies cited. Exit interview was conducted with the Administrator and a copy of this report were provided.the state’s words, verbatim · CDSS document, Aug 12, 2025

Type of visit: Required - 1 Year

On 07/08/2025 at 9:05 AM, Licensing Program Analyst (LPA) P. Manalo arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Lauro Cayabyab, and explained the purpose of the visit. Administrator certificate is current and expires on 11/28/2025. LPA toured facility inside and out including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 6 total bedrooms which 5 bedrooms are occupied by the residents and 1 bedroom is occupied by staff. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. A comfortable temperature is maintained at 72 degrees Fahrenheit. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. Residents’ bathrooms are equipped with grab bars and non-skid mats. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 08/20/2024. At 9:48 AM, LPA reviewed 5 residents records. At 10:15 AM, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. At 11:45 AM, LPA reviewed two samples of residents’ medications. Continue to LIC809-C... Continue from LIC809... THE FOLLOWING DEFICIENCIES WERE OBSERVED DURING VISIT: At 9:35 AM, LPA observed the hot water temperature measured at 136.2 degrees F. At 9:19 AM, LPA observed cleaning chemicals unlocked in the laundry room and Lysol wipes in bedroom #5. At 9:23 AM, LPA observed unlocked medication in the kitchen fridge, prescribed medications in residents' room, TUMS, and etc. At 10:35 AM, LPA observed a resident occupying the designated staff room. At 10:36 AM, record review showed that all the residents' files were incomplete. At 10:55 AM, record review showed that the facility does not have documentation of emergency drills being conducted. At 12:08 PM, LPA observed R1, R2, and R4 with half bed rail with no doctor's order. At 12:10 PM, record review revealed that there are no doctor's order for residents' medications. The Facility was cited from the California Code of Regulations, Title 22 and/or Health and Safety Code Failure to correct deficiencies by POC date may result in additional Civil Penalties. Exit interview conducted with Administrator. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Jul 8, 2025

The state marks this report as 15 pages; the online copy we transcribed has 7. You can request the full file from the county licensing office.

Type of visit: Required - 1 Year

On 08/19/2024 at 11:20 AM, Licensing Program Analysts (LPAs) P. Manalo and Jill Clancy-Czuleger arrived unannounced to conduct 1-Year Annual Required inspection. LPA met with Administrator, Larry Cayabyab and explained the purpose of the visit. Administrator certificate is current (#700256740). LPA toured facility including but not limited to bedrooms, bathrooms, kitchen, common area and backyard. The facility consists of 5 total bedrooms which 5 bedrooms are occupied by the residents. All outdoor and indoor passageways are kept free of obstruction. There are no bodies of water observed. LPA observed lighting in all rooms are adequate for the comfort and safety of the residents. A comfortable temperature is maintained at 75 degrees Fahrenheit. The hot water temperature in the residents’ shared bathroom was measured at 114.6 degrees Fahrenheit. Residents’ bathrooms are equipped with grab bars and non-skid mats. There is a minimum of one week supply of nonperishable and 2-day of perishable foods. Centrally stored medication and sharps were locked and inaccessible to residents. Smoke detectors and carbon monoxide detector were in operating condition during visit. Fire extinguisher was last serviced on 08/16/2023. At 12:10 P.M, LPA reviewed 5 residents records. At 11:45 A.M, LPA reviewed 3 staff records and 3 of 3 have current first aid training and associated to the facility. The following deficiencies were observed: Nail polish remover was found in common area. The Facility was cited, and citations can be found on the LIC 809-D. Exit interview conducted. Appeal Rights and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 19, 2024

Type of visit: Case Management - Other

While at the facility for the annual inspection on 08/19/2024, Licensing Program Analysts (LPAs) P. Manalo and J. Clancy-Czuleger requested updated copies of the following documents: LIC 308 Designation of Administrative Responsibility LIC 309 Administrative Organization LIC 500 Personnel Report LIC 610E Emergency Disaster Plan Liability Insurance Current Administrator’s Certificate Administrator Larry Cayabyab agrees to submit the documents to CCLD by // Exit interview conducted and a copy of this report provided.the state’s words, verbatim · CDSS document, Aug 19, 2024